The right intervention, at the right time, in the right place…

Stephanie Robinson is an occupational therapist at Harrogate hospital working as the  frailty team leader across the medical elderly wards and previously seconded into the Supported Discharge Service. She has had a key role in cross boundary working, outreaching from frail elderly inpatient based wards to the community.

The right intervention, at the right time, in the right place… How Harrogate District Foundation Trust therapists from the community and in-patient wards are tackling the national bed crisis: piloting a Supported Discharge Service.

The pressure is on in Harrogate – the population of over 60s is 26.5% compared to 22.4% nationally.  By 2030 the district’s over 65 population is predicted to increase by 15,000 people.  One of the Trust’s strategic aims for the next five years is to integrate acute, community and social care to allow patients to be treated closer to home, or at home and reduce reliance on acute beds.  It is understood that therapy assessments completed in a patient’s own home are a more accurate reflection of their capabilities than those completed in the hospital environment.  Based on the Discharge to Assess model, the concept that the hospital is often not the most appropriate place for patients of any age to remain is not a new one.

We must do more to ensure no-one misses out on rehab

Professor Karen Middleton is Chief Executive of the Chartered Society of Physiotherapy. Karen is a Fellow of the Society of Orthopaedic Medicine, and, in that capacity, has taught physiotherapists and GPs on a national and international basis. Here she discusses the report Recovering after a hip fracture:
helping people understand physiotherapy in the NHS.

It’s the overwhelming feelings of regret and loss that get me. Every time. Whenever I hear a family member say they ‘can only wonder what might have been’ or a patient talking about what they can no longer do.

Whenever I see our Rehab Matters film I know that the fictional story it depicts is playing out in real life, behind closed doors, in homes across the country. It cuts deeply, as a physiotherapist, to hear these stories of how a lack of access to rehabilitation has changed a life.

It makes me burn at the injustice of so many people missing out. Because I know how access to high-quality rehabilitation can change a life for the better – how it can return a person to the things they love, and to the things they do with the people they love. How it can restore independence and a sense of self-worth. How it can restore a life; how it can save a life. 

Some things in life are free!

Cliff Kilgore is a Consultant Nurse for Intermediate Care and Older People within Dorset Healthcare NHS Trust and he is also a Visiting Fellow to Bournemouth University. He is Chair of the BGS Nurses and Allied Healthcare Professionals Council. He also is a member of the BGS Clinical Quality Steering Group. He tweets @kilgore_cliff

Many of our readers will know that the BGS has been at the forefront of promoting older people’s healthcare and wellbeing for many years. In fact, we celebrated 70 years of this in March. Leading the way for older people has enabled the BGS to have great influence on many aspects of policy and guidance including Fit for Frailty, The Silver Book, Comprehensive Geriatric Assessment (CGA), as well as ever increasing influence on training and development of all clinicians. The BGS has long recognised the importance of developing trainees and to support this has offered many benefits to its members including free membership for medical students and foundation doctors, study grants and sponsorship and support of research projects.

Why do allied health professionals need to be empowered?

Esther Clift is a Clinical Specialist Physiotherapist in Southampton, and a BGS member. In December she attended a conference for allied health professionals at The King’s Fund, chaired by BGS President David Oliver.

Last month, The King’s Fund put on a well subscribed event entitled ‘Empowering Allied Health Professionals to Transform Health and Care Services’.

That title set me wondering: why would we need to be empowered? After all, AHPs like me already make up a significant proportion of the health and social care workforce. 172,686 of us are registered with the Health and Care Professions Council, and yet it seems we are often lumped into an amorphous group of ‘doctors and nurses’ who deliver health care.

Is that just because too few people (even those who should know better) can name more than three or four of the twelve professions under the ‘allied’ banner?  Do we have a crisis of identity?

Calling all Rising Stars!

Do you have a colleague who does  excellent work in geriatric medicine, and deserves to be recognised for it? Do you feel that you do outstanding work and would like to be recognised for it?

Well, the BGS is launching an award today  which can help that to happen!

Nominations for the BGS Rising Star Award 2014 open today. We would like to make two Rising Star Awards each year:

1. One for research contributions that have translated into, or are in the process of being translated into, improvements to the care of older people.
2. One for a clinical quality project which improves the care of older people with frailty in your locality.

What actually is frailty?

Chris Beech is a Nurse Consultant at NHS Forth Valley, Falkirk. She is member of the BGS Specialist Nurse and Allied Health Professionals Special Interest Group.

Frailty is all around us, especially when you take a quick peek at the recent literature on working with older people. It is important that nurses working with older people in all care settings are aware of what frailty is, what the implications are if someone is identified as living with frailty and what, if anything, can be done about it.

We all have a picture in our head of a frail person, the problem is that there is a big chance that this picture is a different image to the one the person sitting next to you is thinking of. It is important therefore to have the ability to put an objective view point into play.

Let’s hear it for Allied Healthcare Professionals

Prof David Oliver is a Consultant Geriatrician in Berkshire and a visiting Professor in Medicine of Older People at City University, London. He is President Elect of the British Geriatrics Society.

David writes in the King’s Fund blog on the how critical the work of Allied Healthcare Professionals (AHPs) is to the care of older people:

Reflecting on our recent paper on the NHS and social care workforce, modern health care is a team venture. It is impossible to deliver effective care without the crucial contribution of highly trained allied health professionals (or AHPs). I look after older people with complex needs for a living. Alongside multiple co-morbidities, many have social vulnerability, functional impairment or communication difficulties which complicate the acute problem they presented with. This is the reality of modern hospital case-mix. Both Francis Inquiries recognised that it was the care of such frail older patients that had caused most concern.

[…] It’s high time we gave AHPs overdue recognition as key players in services that are now team ventures. Population demographics mean that increasingly the business of health care will be the business of caring for older people who require a genuinely multidisciplinary approach. We can’t do it without them.

Read the full article on the Kings Fund blog here.